2023美国心脏协会与美国儿科学会新生儿复苏指南要点更新解读

doi:10.7499/j.issn.1008-8830.2311107

Abstract
Figure/Table
References(60)
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (502 KB) HTML
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract In November 2023, the American Heart Association and the American Academy of Pediatrics jointly released key updates to the neonatal resuscitation guidelines based on new clinical evidence. This update serves as an important supplement to the "Neonatal resuscitation: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care". The aim of this paper is to outline the key updates and provide guidance on umbilical cord management and the selection of positive pressure ventilation equipment and its additional interfaces in neonatal resuscitation.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHU Tian
	SHI Yuan

Key words： Resuscitation Umbilical cord clamping Positive pressure ventilation American Heart Association American Academy of Pediatrics Neonate

Received: 21 November 2023

Cite this article:

ZHU Tian,SHI Yuan. Interpretation of 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation guidelines[J]. CJCP, 2024, 26(1): 25-30.

URL:

http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2311107 OR http://www.zgddek.com/EN/Y2024/V26/I1/25

	Gomersall J, Berber S, Middleton P, et al. Umbilical cord management at term and late preterm birth: a meta-analysis[J]. Pediatrics, 2021, 147(3): e2020015404. PMID: 33632933. DOI: 10.1542/peds.2020-015404.
	Seidler AL, Gyte GML, Rabe H, et al. Umbilical cord management for newborns <34 weeks' gestation: a meta-analysis[J]. Pediatrics, 2021, 147(3): e20200576. PMID: 33632931. PMCID: PMC7924139. DOI: 10.1542/peds.2020-0576.
	Trevisanuto D, Roehr CC, Davis PG, et al. Devices for administering ventilation at birth: a systematic review[J]. Pediatrics, 2021, 148(1): e2021050174. PMID: 34135096. DOI: 10.1542/peds.2021-050174.
	Yamada NK, McKinlay CJ, Quek BH, et al. Supraglottic airways compared with face masks for neonatal resuscitation: a systematic review[J]. Pediatrics, 2022, 150(3): e2022056568. PMID: 35948789. DOI: 10.1542/peds.2022-056568.
	Yamada NK, Szyld E, Strand ML, et al. 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care[J/OL]. Circulation[Preprint]. (2023-11-16) [2023-11-18]. PMID: 37970724. DOI: 10.1161/CIR.0000000000001181.
	Aziz K, Lee HC, Escobedo MB, et al. Part 5: neonatal resuscitation: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care[J]. Circulation, 2020, 142(16_suppl_2): S524-S550. PMID: 33081528. DOI: 10.1161/CIR.0000000000000902.
	American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Delayed umbilical cord clamping after birth: ACOG committee opinion, number 814[J]. Obstet Gynecol, 2020, 136(6): e100-e106. PMID: 33214530. DOI: 10.1097/AOG.0000000000004167.
	American Academy of Pediatrics. Delayed umbilical cord clamping after birth[J]. Pediatrics, 2017, 139(6): 0957-2017. PMID: 28562299. DOI: 10.1542/peds.2017-0957.
	Backes CH, Huang H, Cua CL, et al. Early versus delayed umbilical cord clamping in infants with congenital heart disease: a pilot, randomized, controlled trial[J]. J Perinatol, 2015, 35(10): 826-831. PMID: 26226244. PMCID: PMC5095614. DOI: 10.1038/jp.2015.89.
	Ceriani Cernadas JM, Carroli G, Pellegrini L, et al. The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial[J]. Pediatrics, 2006, 117(4): e779-e786. PMID: 16567393. DOI: 10.1542/peds.2005-1156.
	Chopra A, Thakur A, Garg P, et al. Early versus delayed cord clamping in small for gestational age infants and iron stores at 3 months of age: a randomized controlled trial[J]. BMC Pediatr, 2018, 18(1): 234. PMID: 30021580. PMCID: PMC6052555. DOI: 10.1186/s12887-018-1214-8.
	Datta BV, Kumar A, Yadav R. A randomized controlled trial to evaluate the role of brief delay in cord clamping in preterm neonates (34-36 weeks) on short-term neurobehavioural outcome[J]. J Trop Pediatr, 2017, 63(6): 418-424. PMID: 28204778. DOI: 10.1093/tropej/fmx004.
	13 Al-Tawil MM, Abdel-Aal MR, Kaddah MA. A randomized controlled trial on delayed cord clamping and iron status at 3-5 months in term neonates held at the level of maternal pelvis[J]. J Neonatal-Perinat Med, 2012, 5(4): 319-326. DOI: 10.3233/NPM-1263112.
	Chaparro CM, Neufeld LM, Tena Alavez G, et al. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomised controlled trial[J]. Lancet, 2006, 367(9527): 1997-2004. PMID: 16782490. DOI: 10.1016/S0140-6736(06)68889-2.
	Chen X, Li X, Chang Y, et al. Effect and safety of timing of cord clamping on neonatal hematocrit values and clinical outcomes in term infants: a randomized controlled trial[J]. J Perinatol, 2018, 38(3): 251-257. PMID: 29255190. DOI: 10.1038/s41372-017-0001-y.
	De Paco C, Herrera J, Garcia C, et al. Effects of delayed cord clamping on the third stage of labour, maternal haematological parameters and acid-base status in fetuses at term[J]. Eur J Obstet Gynecol Reprod Biol, 2016, 207: 153-156. PMID: 27863273. DOI: 10.1016/j.ejogrb.2016.10.031.
	Emhamed MO, van Rheenen P, Brabin BJ. The early effects of delayed cord clamping in term infants born to Libyan mothers[J]. Trop Doct, 2004, 34(4): 218-222. PMID: 15510946. DOI: 10.1177/004947550403400410.
	18 Fawzy AEMA, Moustafa AA, El-Kassar YS, et al. Early versus delayed cord clamping of term births in Shatby Maternity University Hospital[J]. Progresos de Obstetricia y Ginecología, 2015, 58(9): 389-392. DOI: 10.1016/j.pog.2015.05.001.
	Jahazi A, Kordi M, Mirbehbahani NB, et al. The effect of early and late umbilical cord clamping on neonatal hematocrit[J]. J Perinatol, 2008, 28(8): 523-525. PMID: 18596716. DOI: 10.1038/jp.2008.55.
	Mohammad K, Tailakh S, Fram K, et al. Effects of early umbilical cord clamping versus delayed clamping on maternal and neonatal outcomes: a Jordanian study[J]. J Matern Fetal Neonatal Med, 2021, 34(2): 231-237. PMID: 30931665. DOI: 10.1080/14767058.2019.1602603.
	Philip AG. Further observations on placental transfusion[J]. Obstet Gynecol, 1973, 42(3): 334-343. PMID: 4724403.
	Salari Z, Rezapour M, Khalili N. Late umbilical cord clamping, neonatal hematocrit and Apgar scores: a randomized controlled trial[J]. J Neonatal Perinatal Med, 2014, 7(4): 287-291. PMID: 25468616. DOI: 10.3233/NPM-1463913.
	Ultee CA, van der Deure J, Swart J, et al. Delayed cord clamping in preterm infants delivered at 34 36 weeks' gestation: a randomised controlled trial[J]. Arch Dis Child Fetal Neonatal Ed, 2006, 93(1): F20-F23. PMID: 17307809. DOI: 10.1136/adc.2006.100354.
	Vural I, Ozdemir H, Teker G, et al. Delayed cord clamping in term large-for-gestational age infants: a prospective randomised study[J]. J Paediatr Child Health, 2019, 55(5): 555-560. PMID: 30288843. DOI: 10.1111/jpc.14242.
	Yadav AK, Upadhyay A, Gothwal S, et al. Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial[J]. J Perinatol, 2015, 35(9): 720-724. PMID: . DOI: 10.1038/jp.2015.65.
	Katheria AC, Clark E, Yoder B, et al. Umbilical cord milking in nonvigorous infants: a cluster-randomized crossover trial[J]. Am J Obstet Gynecol, 2023, 228(2): 217.e1-217.e14. PMID: 26087318. DOI: 10.1016/j.ajog.2022.08.015.
	27 Armanian AM, Tehrani HG, Ansari M, et al. Is "delayed umbilical cord clamping" beneficial for premature newborns?[J]. Int J Pediatr, 2016, 5(5): 4909-4918. DOI: 10.22038/ijp.2016.7909.
	Backes CH, Huang H, Iams JD, et al. Timing of umbilical cord clamping among infants born at 22 through 27 weeks' gestation[J]. J Perinatol, 2016, 36(1): 35-40. PMID: 26401752. PMCID: PMC5095613. DOI: 10.1038/jp.2015.117.
	Baenziger O, Stolkin F, Keel M, et al. The influence of the timing of cord clamping on postnatal cerebral oxygenation in preterm neonates: a randomized, controlled trial[J]. Pediatrics, 2007, 119(3): 455-459. PMID: 17332197. DOI: 10.1542/peds.2006-2725.
	Das B, Sundaram V, Kumar P, et al. Effect of placental transfusion on iron stores in moderately preterm neonates of 30-33 weeks gestation[J]. Indian J Pediatr, 2018, 85(3): 172-178. PMID: 29101631. DOI: 10.1007/s12098-017-2490-2.
	Duley L, Dorling J, Pushpa-Rajah A, et al. Randomised trial of cord clamping and initial stabilisation at very preterm birth[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(1): F6-F14. PMID: 28923985. PMCID: PMC5750367. DOI: 10.1136/archdischild-2016-312567.
	Hofmeyr GJ, Bolton KD, Bowen DC, et al. Periventricular/intraventricular haemorrhage and umbilical cord clamping. Findings and hypothesis[J]. S Afr Med J, 1988, 73(2): 104-106. PMID: 3340910.
	Hofmeyr GJ, Gobetz L, Bex PJ, et al.Periventricular/intraventricular hemorrhage following early and delayed umbilical cord clamping. A randomized controlled trial[J]. Online J Curr Clin Trials, 1993: Doc No 110. PMID: 8305996.
	Kinmond S, Aitchison TC, Holland BM, et al. Umbilical cord clamping and preterm infants: a randomised trial[J]. BMJ, 1993, 306(6871): 172-175. PMID: 8443480. PMCID: PMC1676623. DOI: 10.1136/bmj.306.6871.172.
	Kugelman A, Borenstein-Levin L, Riskin A, et al. Immediate versus delayed umbilical cord clamping in premature neonates born <35 weeks: a prospective, randomized, controlled study[J]. Am J Perinatol, 2007, 24(5): 307-315. PMID: 17516307. DOI: 10.1055/s-2007-981434.
	McDonnell M, Henderson-Smart DJ. Delayed umbilical cord clamping in preterm infants: a feasibility study[J]. J Paediatr Child Health, 1997, 33(4): 308-310. PMID: 9323618. DOI: 10.1111/j.1440-1754.1997.tb01606.x.
	Mercer JS, McGrath MM, Hensman A, et al. Immediate and delayed cord clamping in infants born between 24 and 32 weeks: a pilot randomized controlled trial[J]. J Perinatol, 2003, 23(6): 466-472. PMID: 13679933. DOI: 10.1038/sj.jp.7210970.
	Mercer JS, Vohr BR, Erickson-Owens DA, et al. Seven-month developmental outcomes of very low birth weight infants enrolled in a randomized controlled trial of delayed versus immediate cord clamping[J]. J Perinatol, 2010, 30(1): 11-16. PMID: 19847185. PMCID: PMC2799542. DOI: 10.1038/jp.2009.170.
	Oh W, Fanaroff AA, Carlo WA, et al. Effects of delayed cord clamping in very-low-birth-weight infants[J]. J Perinatol, 2011, 31: S68-S71. PMID: 21448208. PMCID: PMC3327157. DOI: 10.1038/jp.2010.186.
	Rabe H, Wacker A, Hülskamp G, et al. A randomised controlled trial of delayed cord clamping in very low birth weight preterm infants[J]. Eur J Pediatr, 2000, 159(10): 775-777. PMID: 11039135. DOI: 10.1007/pl00008345.
	Ruangkit C, Bumrungphuet S, Panburana PY, et al. A randomized controlled trial of immediate versus delayed umbilical cord clamping in multiple-birth infants born preterm[J]. Neonatology, 2019, 115(2): 156-163. PMID: 30481760. DOI: 10.1159/000494132.
	Tarnow-Mordi W, Morris J, Kirby A, et al. Delayed versus immediate cord clamping in preterm infants[J]. N Engl J Med, 2017, 377(25): 2445-2455. PMID: 29081267. DOI: 10.1056/NEJMoa1711281.
	董小玥, 孙小凡, 李萌萌, 等. 延迟脐带结扎对胎龄<32周早产儿的影响[J]. 中国当代儿科杂志, 2016, 18(7): 635-638. PMID: 27412548. PMCID: PMC7388993. DOI: 10.7499/j.issn.1008-8830.2016.07.013.
	Gokmen Z, Ozkiraz S, Tarcan A, et al. Effects of delayed umbilical cord clamping on peripheral blood hematopoietic stem cells in premature neonates[J]. J Perinat Med, 2011, 39(3): 323-329. PMID: 21391876. DOI: 10.1515/jpm.2011.021.
	Dipak NK, Nanavat RN, Kabra NK, et al. Effect of delayed cord clamping on hematocrit, and thermal and hemodynamic stability in preterm neonates: a randomized controlled trial[J]. Indian Pediatr, 2017, 54(2): 112-115. PMID: 28285280. DOI: 10.1007/s13312-017-1011-8.
	Finn D, Ryan DH, Pavel A, et al. Clamping the umbilical cord in premature deliveries (CUPiD): neuromonitoring in the immediate newborn period in a randomized, controlled trial of preterm infants born at <32 weeks of gestation[J]. J Pediatr (Rio J), 2019, 208: 121-126. PMID: 30879732. DOI: 10.1016/j.jpeds.2018.12.039.
	Rana A, Agarwal K, Ramji S, et al. Safety of delayed umbilical cord clamping in preterm neonates of less than 34 weeks of gestation: a randomized controlled trial[J]. Obstet Gynecol Sci, 2018, 61(6): 655-661. PMID: 30474011. PMCID: PMC6236088. DOI: 10.5468/ogs.2018.61.6.655.
	Elimian A, Goodman J, Escobedo M, et al. Immediate compared with delayed cord clamping in the preterm neonate: a randomized controlled trial[J]. Obstet Gynecol, 2014, 124(6): 1075-1079. PMID: 25415157. DOI: 10.1097/AOG.0000000000000556.
	El-Naggar W, Simpson D, Hussain A, et al. Cord milking versus immediate clamping in preterm infants: a randomised controlled trial[J]. Arch Dis Child Fetal Neonatal Ed, 2019, 104(2): F145-F150. PMID: 29903720. DOI: 10.1136/archdischild-2018-314757.
	Hosono S, Mugishima H, Fujita H, et al. Umbilical cord milking reduces the need for red cell transfusions and improves neonatal adaptation in infants born at less than 29 weeks' gestation: a randomised controlled trial[J]. Arch Dis Child Fetal Neonatal Ed, 2008, 93(1): F14-F19. PMID: 17234653. DOI: 10.1136/adc.2006.108902.
	Katheria A, Blank D, Rich W, et al. Umbilical cord milking improves transition in premature infants at birth[J]. PLoS One, 2014, 9(4): e94085. PMID: 24709780. PMCID: PMC3978008. DOI: 10.1371/journal.pone.0094085.
	Katheria AC, Leone TA, Woelkers D, et al. The effects of umbilical cord milking on hemodynamics and neonatal outcomes in premature neonates[J]. J Pediatr, 2014, 164(5): 1045-1050.e1. PMID: 24560179. DOI: 10.1016/j.jpeds.2014.01.024.
	Kilicdag H, Gulcan H, Hanta D, et al. Is umbilical cord milking always an advantage?[J]. J Matern Fetal Neonatal Med, 2016, 29(4): 615-618. PMID: 25731653. DOI: 10.3109/14767058.2015.1012067.
	Li J, Yu B, Wang W, et al. Does intact umbilical cord milking increase infection rates in preterm infants with premature prolonged rupture of membranes?[J]. J Matern Fetal Neonatal Med, 2020, 33(2): 184-190. PMID: 29886779. DOI: 10.1080/14767058.2018.1487947.
	March MI, Hacker MR, Parson AW, et al. The effects of umbilical cord milking in extremely preterm infants: a randomized controlled trial[J]. J Perinatol, 2013, 33(10): 763-767. PMID: 23867960. PMCID: PMC3916936. DOI: 10.1038/jp.2013.70.
	Mercer JS, Erickson-Owens DA, Vohr BR, et al. Effects of placental transfusion on neonatal and 18 month outcomes in preterm infants: a randomized controlled trial[J]. J Pediatr (Rio J), 2016, 168: 50-55. PMID: 26547399. PMCID: PMC4698069. DOI: 10.1016/j.jpeds.2015.09.068.
	Silahli M, Duman E, Gokmen Z, et al. The relationship between placental transfusion, and thymic size and neonatal morbidities in premature infants: a randomized control trial[J]. J Pak Med Assoc, 2018, 68(11): 1560-1565. PMID: 30410129.
	Song SY, Kim Y, Kang BH, et al. Safety of umbilical cord milking in very preterm neonates: a randomized controlled study[J]. Obstet Gynecol Sci, 2017, 60(6): 527-534. PMID: 29184860. PMCID: PMC5694726. DOI: 10.5468/ogs.2017.60.6.527.
	Alan S, Arsan S, Okulu E, et al. Effects of umbilical cord milking on the need for packed red blood cell transfusions and early neonatal hemodynamic adaptation in preterm infants born ≤1 500 g: a prospective, randomized, controlled trial[J]. J Pediatr Hematol Oncol, 2014, 36(8): e493-e498. PMID: 24633297. DOI: 10.1097/MPH.0000000000000143.
	Katheria A, Reister F, Essers J, et al. Association of umbilical cord milking vs delayed umbilical cord clamping with death or severe intraventricular hemorrhage among preterm infants[J]. JAMA, 2019, 322(19): 1877-1886. PMID: 31742630. PMCID: PMC6865839. DOI: 10.1001/jama.2019.16004.